Cardiovascular disease is a class of diseases that greatly threaten human health. In recent years, with the continuous improvement of living standards, both the morbidity rate and mortality rate of the diseases show an upward trend all over the world. Hypertension, one of the most common cardiovascular diseases in the world, is a long term chronic disease, which can cause systemic arteriolospasm at early stage and atherosclerosis at late stage, and further cause lesions of important organs such as myocardial infarction, stroke and kidney failure, thereby seriously threatening human health and life. The prevalence rate of hypertension reaches about 10%, and even 20% in some developed countries. According to the statistics, there are more than 1 billion patients with hypertension in the whole world. China has become a country with a high morbidity rate of hypertension, and the morbidity rate has increased rapidly in recent 20 years. From now on, with the increasing pace of social life, the reducing of manual labor day by day, and the trend of diet towards high calories and high fats, an upward trend in the number of patients with hypertension will last for a long period.
In recent, calcium antagonists, β-receptor blockers, ACE inhibitors, and angiotensin antagonists are four main drugs in international antihypertensive drug market. Among them, β-receptor blocker is a best-selling drug that ranks second only to calcium antagonists such as amlodipine. Metoprolol succinate (1-isopropylamino-3-[p-(2-methoxyethyl)phenoxy]-2-propanol L(+)-succinate) (Formula I), the second generation β-receptor blocker antihypertensive drug, is highly selective for heart, is effective in reducing blood pressure, slowing heartbeat, improving myocardial ischemia, and improving heart function, and therefore is widely used in the treatment of hypertension, coronary disease, arrhythmia, and chronic cardiac insufficiency.

Hydrochlorothiazide (6-chloro-3,4-dihydro-2H-1,2,4-benzothiadiazine-7-sulfamide-1,1-dioxide, Formula II) is a diuretic. Thiazines influence resorption mechanism of electrolytes in kidney tubules, and increase excretion of sodium ion and chlorine ion. The diuretic effect of hydrochlorothiazide indirectly reduces blood plasma volume, accompanied by an increase in plasma renin activity, an increase in aldosterone system activity, an increase in Na+—K+ exchange, and a decrease in potassium in serum. The antihypertensive mechanism of thiazine diuretics is not clear yet, and it is generally believed that sodium excretion is primarily responsible for the antihypertensive effect. Thiazine diuretics can be used alone or in combination with other antihypertensive drugs, mainly for the treatment of primary hypertension. It is suggested in JNC 7 that hydrochlorothiazide is used as basic drug for antihypertensive treatment. When two drugs are used in combination, the combination of diuretic with one of ACEI, ARB and β receptor blockers is recommended. The dose of hydrochlorothiazide can be reduced when used in combination (Medical Research and Education, 2012, 29(2): 69-71).

The compound preparation of metoprolol succinate and hydrochlorothiazide exhibits a synergistic effect with respect to anti-hypertension. β receptor blockers reduce blood pressure by mediating the decrease in cardiac output and inhibiting the activity of renin. When β receptor blocker is used in combination with thiazine diuretic, the inhibition of aldosterone system activity is attenuated, and therefore their compound preparation exhibits a synergistic effect with respect to anti-hypertension. Moreover, the use of diuretic in combination enhances the effect of β receptor blocker in melanoderm and patients with low renin hypertension (J Am Soc Hypertens, 2010, 4(2): 90-98).
The patent (Publication No. CN103142618A) discloses a method for preparing a sustained-release capsule of metoprolol succinate and hydrochlorothiazide, wherein sustained-release pellet of metoprolol is prepared by pellet coating technique, the formula of the sustained-release coating is complex, and the coating formula is not reasonable enough. When water insoluble coating is used as coating material to prepare a sustained-release pellet, it has a good film-forming property but a poor permeability, and cannot ensure the release of active drug at an ideal release rate unless it is used in combination with other water soluble substance (referred to hereafter as pore-forming agent). However, when a pore-forming agent is a traditional hydrophilic polymer material, it can result in a lagging phase at early stage of drug release. When such a sustained-release preparation runs into gastrointestinal digestive juice upon oral administration, water permeates into the inside of pellet from outside through the controlled-release film, and has the drug dissolved; with gradual dissolution of the drug, the osmotic pressure increases gradually. When the osmotic pressure increases to a certain value, the drug diffuses through the film from inside to outside, i.e., drug release begins. Therefore, such sustained-release preparations cannot release drug immediately upon oral administration, and have to undergo a lagging phase of “moisture permeation, drug dissolution, and generation of osmotic pressure”. Due to the delayed drug release of such sustained-release preparations, their therapeutic effect may be affected (International Journal of Pharmaceutics, 2011, 411:43-48). Therefore, there is still a demand in the art for a sustained-release composition comprising metoprolol, the preparation method of which is simple and the drug release of which is ideal.
Contents of Invention
After paying a lot of creative work, the inventors of the invention provide a sustained-release composition comprising metoprolol, the drug release of which is ideal and the preparation method of which is simple, and a combination product comprising the sustained-release composition and a pharmaceutical composition comprising hydrochlorothiazide, and thus accomplish the invention.
In a first aspect, the invention relates to a sustained-release composition comprising metoprolol, wherein said composition comprises a blank pellet core, an active constituent layer and a sustained-release coating layer, characterized in that said sustained-release coating layer comprises the active constituent, wherein said active constituent is selected from the group consisting of a free base of metoprolol, an optical isomer of metoprolol and a pharmaceutically acceptable salt of metoprolol.
In the invention, said pharmaceutically acceptable salt of metoprolol is selected from the group consisting of metoprolol succinate, tartrate, fumarate, sorbate, laurate, and hydrochloride.
The sustained-release composition according to any item of the first aspect of the invention, wherein said sustained-release coating layer comprises a sustained release material, the sustained release material may be any sustained-release material well known in the art, including, but not limited to: cellulose compound (e.g., ethyl cellulose), Eudragit NE 30D, Eudragit RS 30D, Eudragit RL30D or a mixture thereof, preferably ethyl cellulose having different viscosity, most preferably ethyl cellulose having a viscosity within a range of 9 mPa·s-22 mPa·s, such as Ethocel Standard 10 Premium.
The sustained-release composition according to any item of the first aspect of the invention, wherein said active constituent layer comprises or does not comprise an adhesive.
In the invention, said adhesive may be any adhesive well known in the art, including, but not limited to: one of starch paste, syrup, polyvinylpyrrolidone (povidone, PVP, such as PVP K30), methyl cellulose (MC), ethyl cellulose (EC), high-substituted hydroxypropyl cellulose (H-HPC), hydroxypropyl methyl cellulose (HPMC), carboxymethyl cellulose sodium, gelatin, and arabica acacia, or a mixture of two or more of them. If the active constituent layer comprises no adhesive, when a drug is loaded to a blank pellet core, the period of time for drug-loading is short, the drug-loading rate is high, and the drug can be provided in a constant release rate.
The sustained-release composition according to any item of the first aspect of the invention, wherein said sustained-release coating layer comprises the active constituent in a certain proportion, the active constituent comprised therein and optionally an additional pore-forming substance (e.g., hydroxypropyl cellulose) co-act as a pore-forming agent, i.e., the active constituent alone acts as a pore-forming agent, or the active constituent and an additional pore-forming substance (e.g., hydroxypropyl cellulose) co-act as a pore-forming agent.
In the invention, said additional pore-forming substance refers to a pore-forming agent other than the active constituent, including, but not limited to: polyethylene glycol, povidone, sucrose, salt, hydroxypropyl cellulose, hydroxypropyl methylcellulose, active drug, and the like or a mixture thereof. In an embodiment of the invention, said additional pore-forming substance is hydroxypropyl cellulose, preferably hydroxypropyl cellulose (HPC) having a viscosity within a range of 75 cpc-150 cpc, e.g., Klucel LF Type hydroxypropyl cellulose.
The sustained-release composition according to any item of the first aspect of the invention, wherein the sustained-release material and the pore-forming agent (i.e., the active constituent alone as a pore-forming agent or a combination of the active constituent and the additional pore-forming agent in the sustained-release coating layer) is in a weight ratio of 1:0.1˜1:0.4, e.g., 1:0.1˜1:0.3, e.g., 1:0.1˜1:0.25, e.g., 1:0.1˜1:0.225, e.g., 1:0.1˜1:0.2, e.g., 1:0.1˜1:0.15, e.g., 1:0.15˜1:0.3, e.g., 1:0.15˜1:0.25, e.g., 1:0.1˜1:0.225, e.g., 1:0.1˜1:0.2, e.g., 1:0.2˜1:0.3, e.g., 1:0.2˜1:0.25, e.g., 1:0.225˜1:0.3, e.g., 1:0.225˜1:0.25, e.g., 1:0.25˜1:0.3, e.g., 1:0.25.
The sustained-release composition according to any item of the first aspect of the invention, wherein the active constituent and the additional pore-forming substance (e.g., hydroxypropyl cellulose) in the sustained-release coating layer is in a weight ratio of 1:3˜3:1, e.g., 1:2˜2:1, e.g., 1:1, e.g., 1:0.8.
The sustained-release composition according to any item of the first aspect of the invention, wherein the sustained-release coating causes a weight gain of 20%˜60%, e.g., 30%˜50%, e.g., 35%˜45%.
The sustained-release composition according to any item of the first aspect of the invention, wherein the active constituent in the active constituent layer accounts for 40%˜70%, e.g., 45%˜65%, e.g., 50%˜60%, e.g., 50%˜55% of the total weight of the sustained-release composition.
The sustained-release composition according to any item of the first aspect of the invention, wherein said blank pellet core is well known in the art, which, for example, is selected from sucrose pellet core, starch pellet core, microcrystalline cellulose pellet core, or silica pellet core, etc. Said blank pellet core may be purchased from market, or prepared by conventional methods in the art such as method of extruding and round as ball and method of fluidized bed.
The sustained-release composition according to any item of the first aspect of the invention, wherein said blank pellet core has a particle size of 200 μm˜900 μm, e.g., 200 μm˜350 μm.
In the invention, said active constituent layer may further comprise an additional pharmaceutically acceptable adjuvant, which may, for example, be one or more selected from the group consisting of lubricant, surfactant, disintegrant, agent of aromatic taste, agent of sweet taste, anti-adherent and opacifier. Said lubricant includes, but is not limited to: sodium fumaryl stearate, sterotex, magnesium laurylsulfate, high melting-point wax, corn starch or a mixture thereof, preferably sodium fumaryl stearate. Said surfactant includes anion surfactant, cation surfactant, zwitterionic surfactant and nonionic surfactant. Said surfactant includes, but is not limited to: sodium lauryl sulfate, sodium hexadecyl sulfate, sodium octodecyl sulfate, sodium dodecyl benzene sulfonate, sodium dioctyl sulfosuccinate, sodium dihexyl sulfosuccinate, lecithin, sorbitan fatty acid ester, polyoxyethylene sorbitan fatty acid ester, polyoxyethylene aliphatate, polyoxyethylene aliphatic alcohol ether, oxyethylene-oxypropylene polymer, polyoxyethylene 40 stearate, polyoxyethylene 50 stearate, ethylene oxide triblock copolymer, propylene oxide triblock copolymer, sorbitan monopalmitate (Span-40), sorbitan monostearate (Span-60), glycerol monostearate, polyoxyethylene stearate, and the like, or a mixture thereof. Said disintegrant includes, but is not limited to: microcrystalline cellulose, low substituted hydroxypropyl cellulose sodium, cross-linked polyvinylpyrrolidone, sodium carboxymethyl starch, pregelatinized starch, alginic acid, starch, effervescence disintegrant, and the like, or a mixture thereof. Said anti-adherent includes, but is not limited to: talc, magnesium stearate, colloidal silicon dioxide, preferably talc. Said opacifier includes, but is not limited to: titanium dioxide and the like. Said agent of aromatic taste includes, but is not limited to: peppermint essence, lemon essence, orange essence, eudesmol, syringyl alcohol and the like. Said agent of sweet taste includes, but is not limited to: aspartame, vanillin, sorbitol, mannitol, artificial essence and the like.
In the invention, said sustained-release coating layer further comprise one or more selected from the group consisting of lubricant, plasticizer, anti-adherent, colorant, opacifier, agent of aromatic taste and agent of sweet taste. Said lubricant includes, but is not limited to: sodium fumaryl stearate, sterotex, magnesium laurylsulfate, high melting-point wax, corn starch or a mixture thereof, preferably sodium fumaryl stearate. Said plasticizer includes, but is not limited to: glycerol, propylene glycol, polyethylene glycol, glyceryl triacetate, triethyl citrate, phthalate, dibutyl sebacate, and the like, or a mixture thereof, preferably glyceryl triacetate. Said anti-adherent includes, but is not limited to: talc, magnesium stearate, colloidal silicon dioxide and the like, or a mixture thereof, preferably talc. Said opacifier includes, but is not limited to: titanium dioxide and the like. Said colorant includes, but is not limited to: ferrite yellow, iron oxide red, coccinellin, lemon yellow, sunset yellow, indigo blue and the like. Said agent of aromatic taste includes, but is not limited to: peppermint essence, lemon essence, orange essence, eudesmol, syringyl alcohol and the like. Said agent of sweet taste includes, but is not limited to: aspartame, vanillin, sorbitol, mannitol, artificial essence and the like, or a mixture thereof.
In the invention, said sustained-release composition is a sustained-release pellet.
In the invention, metoprolol in a unit preparation may be present in an amount of 1 mg˜500 mg, preferably 5 mg˜300 mg, more preferably 10 mg˜250 mg, most preferably 20 mg˜200 mg, further most preferably 23.75 mg˜190 mg. In an embodiment of the invention, a unit preparation comprises metoprolol succinate in an amount of 23.75 mg. In another embodiment, a unit preparation comprises metoprolol succinate in an amount of 47.5 mg. In another embodiment, a unit preparation comprises metoprolol succinate in an amount of 95 mg.
A cumulative released percentage of the sustained-release composition according to any item of the first aspect of the invention reaches 1˜30 wt % within 1 hour, reaches 30˜55 wt % within 4 hours, reaches 50˜85 wt % within 8 hours, and reaches nearly complete release, e.g., above 80 wt %, e.g., above 85 wt %, e.g., above 90 wt %, e.g., above 95 wt %, e.g., above 99 wt %, e.g., above 100 wt %, within 20 hours, wherein the cumulative released percentage is obtained on basis of the total weight of the sustained-release composition.
Compared to a conventional preparation or a conventional sustained-release preparation at a same dose, the relative oral bioavailability of the sustained-release composition according to any item of the first aspect of the invention is increased to 80%˜120%, e.g., 85%˜115%, e.g., 90%˜110%. The time to peak (Tmax) of the sustained-release composition according to any item of the first aspect of the invention is about 30 min in advance, compared to the reference preparation (Comparative example 1).
In a second aspect, the invention relates to a method for preparing the sustained-release composition according to any item of the first aspect of the invention, comprising the following steps of:
1) dissolving the active constituent and optionally an adjuvant of the active constituent layer in a suitable amount of a solvent to obtain a drug solution, and coating a blank pellet core with the drug solution to obtain a drug loaded pellet, and
2) dissolving a sustained-release coating material, the active constituent and optionally an additional pore-forming substance, as well as an adjuvant of the sustained-release coating layer in a solvent to obtain a solution, and coating the drug loaded pellet obtained in step 1) with the solution.
The method according to the second aspect of the invention, wherein the solvent is selected from the group consisting of water, ethanol, propanol, propylene glycol, chloroform and a mixture thereof. Said mixture is, for example, a mixture of water and ethanol.
In an embodiment of the invention, said method for preparing the sustained-release composition comprising metoprolol is as follows.
a. A sustained-release dose of an active constituent (free bases of metoprolol, optical isomers of metoprolol, or pharmaceutically acceptable salts of metoprolol) is dissolved in water to prepare a drug-containing coating solution at a concentration of 37.5% (w/v). Blank pellet cores are placed in a fluidized bed granulation coating device, and are coated with said drug-containing coating solution under stirring to obtain drug loaded pellets.
b. Ethyl cellulose as a sustained-release coating material is dissolved in an ethanol solution to obtain a concentration within a range of 5-12% (w/v), preferably within a range of 8-10% (w/v), and metoprolol is added in a corresponding dose, dissolved under stirring and heating, mixed homogeneously, and passed through a 100 mesh sieve, and then is atomized and sprayed onto the pellets loaded with metoprolol active constituent layer to perform sustained-release coating in the bottom-spray fluidized bed coating device, thereby obtaining a sustained-release composition comprising metoprolol.
The process parameters for drug-loading coating and sustained-release coating in the fluidized bed can be adjusted depending on practical conditions, the preferred process parameters are as follows.
For drug-loading coating, the temperature of air intake is 60˜70° C. (the temperature in pan is kept within a range of 50±2° C.); the pressure of air intake is 0.3˜0.5 bar; the pressure of atomization is 1.0˜2.0 bar; and the rate of liquid-spraying is 5˜15 g/min.
For sustained-release coating, the temperature of air intake is 40˜45° C. (the temperature in pan is kept within a range of 30˜35° C.); the pressure of air intake is 0.3˜0.5 bar; the pressure of atomization is 1.0˜2.0 bar; the rate of liquid-spraying is 3˜12 g/min.
In a third aspect, the invention relates to a pharmaceutical composition, comprising the sustained-release composition according to any item of the first aspect of the invention, and optionally a pharmaceutically acceptable carrier or excipient.
In a fourth aspect, the invention relates to a combination product, comprising the sustained-release composition according to any item of the first aspect of the invention and a pharmaceutical composition comprising hydrochlorothiazide.
In the combination product according to the fourth aspect of the invention, said sustained-release composition comprising metoprolol and said pharmaceutical composition comprising hydrochlorothiazide can be capsulated into a capsule, or tableted into a tablet, wherein said tablet is, for example, a conventional tablet, double-layer tablet, chewable tablet or orally disintegrating tablet.
In an embodiment of the invention, said pharmaceutical composition comprising hydrochlorothiazide comprises an active agent hydrochlorothiazide, a filler and/or an adhesive, and may further comprise an additional pharmaceutically acceptable adjuvant, such as surfactant, disintegrant, agent of aromatic taste, agent of sweet taste, anti-adherent, opacifier and plasticizer.
The invention also relates to the sustained-release composition according to any item of the first aspect of the invention or the combination product according to any item of the third aspect of the invention, for use in the manufacture of a medicament for preventing or treating a disease such as hypertension, angina, myocardial infarction, hypertrophic cardiomyopathy, aortic dissection, arrhythmia, hyperthyreosis, and cardiac neurosis.
The invention also relates to a method for preventing or treating a disease such as hypertension, angina, myocardial infarction, hypertrophic cardiomyopathy, aortic dissection, arrhythmia, hyperthyreosis, and cardiac neurosis, comprising a step of administering to a subject in need thereof a prophylactically or therapeutically effective amount of the sustained composition according to any item of the first aspect of the invention or the combination product according to any item of the third aspect of the invention.
The invention also relates to the sustained-release composition according to any item of the first aspect of the invention or the combination product according to any item of the third aspect of the invention, for use in the prevention or treatment of a disease such as hypertension, angina, myocardial infarction, hypertrophic cardiomyopathy, aortic dissection, arrhythmia, hyperthyreosis, and cardiac neurosis.
The invention provides a sustained-release composition comprising metoprolol, consisting of the following three parts: a. a blank pellet core; b. an active constituent layer, i.e., a drug layer; and c. a sustained-release coating layer (FIG. 1), wherein the sustained-release coating layer comprises a certain proportion of an active constituent, i.e., metoprolol, that is, the active constituents are present in two forms, respectively, i.e., in the rapid-release part and the sustained-release part, respectively; and the active constituent of the rapid-release part of is present within the controlled-release film, thereby providing a certain drug-release rate at the early stage of release, eliminating the phenomena of delayed-release in the early state of release as commonly seen in conventional film-controlled sustained-release formulations of highly water soluble drugs (International Journal of Pharmaceutics, 2011, 411:43-48), and achieving an effective combination of rapid release and sustained release, and thus having a stable and ideal drug-release profile.
In addition, a certain dose of the active constituent in the sustained-release coating layer can also act as a pore-forming agent, so as to modulate the release of drug. Moreover, the active constituent can not only be used as a pore-forming agent by itself, but also be mixed with a pore-forming agent other than the active constituent in a certain proportion to co-act as a pore-forming agent, so as to better modulate the release of drug and obtain a more ideal drug release profile.
Furthermore, the presence of the active constituent in the sustained-release coating film can eliminate electrostatic adsorption during polymer film coating, to make the coating easily.
In addition, the technical solutions of the invention can reduce the use of adjuvants and effectively enhance the drug-loading amount of a preparation, thereby reducing the volume of the preparation so that the preparation is convenient for administration in a patient.
The sustained-release compositions according to the invention also have the advantages such as simple formula, easy operation, stable quality, strong controllability, and good reproducibility.
In the invention, the term “metoprolol” when used alone, if not specially specified, refers to metoprolol drug, e.g., free base of metoprolol, optical isomer of metoprolol or pharmaceutically acceptable salt of metoprolol.
In the invention, said free base of metoprolol refers to metoprolol that is present in a form of a free single molecule or a multi-molecular aggregate, rather than forming a salt with other organic or inorganic acid.
A person skilled in the art shall realize that metoprolol has a chiral center, said optical isomer of metoprolol according to the invention includes the R- or S-optical isomer. In an embodiment of the invention, said optical isomer of metoprolol has a certain optical purity, with an cc value of, e.g., above 50%, e.g., above 60%, e.g., above 70%, e.g., above 80%, e.g., above 90%, e.g., above 95%, e.g., above 98%, e.g., above 99%, e.g., above 99.9%, e.g., 100%.
In the invention, said sustained-release pellets or said pharmaceutical composition granules comprising hydrochlorothiazide have a particle size of 150 μm˜1500 μm, e.g., 300 μm˜1000 μm, e.g., 400 μm˜850 μm, e.g., 610 μm˜750 μm.
In the invention, the term “pharmaceutically acceptable” generally refers to being useful in pharmaceutical field, not harmful to product or mammal, or having a reasonable or acceptable benefit/risk ratio.
In the invention, the term “carrier” or “excipient” may be any conventional carrier and excipient in pharmaceutical field. The selection of a particular carrier and excipient depends on method of administration or type and state of a disease in a patient to be treated. A method for preparing a suitable pharmaceutical composition for use in a specific method of administration completely falls into the scope of knowledge mastered by a person skilled in the art. For example, pharmaceutically acceptable carrier or excipient include conventional carrier, excipient, diluent, filler, solvent, support agent, adhesive, moistening agent, disintegrant, absorption enhancer, surfactant, adsorption carrier, lubricant, and the like in pharmaceutical field. If necessary, agent of aromatic taste, preservative, agent of sweet taste, and the like may also be included.
In the invention, the term “subject” refers to a subject to which the sustained-release composition according to any item of the first aspect of the invention, the pharmaceutical composition according to any item of the third aspect or the combination product according to any item of the fourth aspect of the invention is administered. In an embodiment of the invention, said subject is mammal, such as human, canine, murine, feline, bovine, equine, or caprid; in a preferred embodiment, said subject is human.
In the invention, said sustained-release composition or combination product is preferably orally administered to a subject.
The administered amount of the sustained-release composition according to any item of the first aspect of the invention, the pharmaceutical composition according to any item of the third aspect or the combination product according to any item of the fourth aspect, depends on many factors, e.g., nature and severity of the disease to be prevented or treated, gender, age, body weight, sensitivity and individual response of a patient or animal, the particular compound used, administration route, administration frequency, the desired therapeutic effect, and the like. Said administered amount may be administered in a single dose or in several (e.g., two, three or four) separate doses. A single maximum dose is generally not greater than 30 mg/Kg body weight, e.g., 0.001-30 mg/Kg, preferably 0.01-5 mg/Kg, and a better dose range is 0.5-2 mg/Kg body weight. However, in some cases, a single dose of above 30 mg/Kg body weight or below 0.001 mg/Kg may also be used.